Calculus retrieving/removing device and method

ABSTRACT

A device for retrieving calculus in a lumen of a living body includes an elongated member positionable in the living body lumen and including an inlet, an outlet and a retrieval space between the inlet and the outlet, and a sealing member movably positioned in the lumen of the elongated member to axially move in distal and proximal directions, wherein the sealing member is in sealing contact with the inner surface of the lumen in the elongated member. A plunger is connected to the sealing member and includes two parts separated from one another to form a divided sealing member when the plunger is moved in the distal direction and that directly contact one another to form an integrated sealing member when the plunger is moved in the proximal direction to draw fluid and the calculus into the retrieval space.

CROSS-REFERENCE TO OTHER APPLICATIONS

This application discloses subject matter related to subject matterdescribed in U.S. application Ser. No. 14/222,021, U.S. application Ser.No. 14/221,954 and U.S. application Ser. No. 14/221,858, the entirecontent of each of which is incorporated herein by reference.

TECHNICAL FIELD

The present invention generally pertains to methods and systems forretrieving/removing a mass from a human body. More specifically, theinvention involves methods and systems for retrieving/removing stone(s)(e.g., calculus or calculi) from a portion of a human body such as therenal pelvis or the ureter.

BACKGROUND DISCUSSION

The term urinary calculus (e.g., kidney stones and ureteral stones)refers to masses or stones, typically solid particles, that form in thehuman body and are located in the kidneys and/or the ureter. They canexhibit a variety of chemical compositions including calcium oxalate,calcium phosphate, uric acid, cystine, and struvite.

Stone disease (e.g., kidney stones and ureteral stones) is a relativelycommon urological disorder. The presence of calculus in the body canmanifest itself in a variety of ways and can produce a number of medicalailments. For example, the presence of calculus in the renal pelvis(kidney) can cause blood in the urine, urinary obstruction, infection,and various degrees of pain ranging from vague frank pain to much moresevere pain not capable of being relieved through general painmedication. The presence of stones or calculi in the ureter can resultin relatively severe side and back pain, pain below the ribs, and painthat sometimes spreads to the lower abdomen and groin, as well as painduring urination and hematuria.

Fortunately, many calculi or stones pass out of the body withoutrequiring any specific medical intervention. In those situations wherethe calculus does not naturally pass out of the body, a medicalprocedure may be required. Known medical procedures typically fall intothree categories.

In the past, three main treatments have been used to address calculus orkidney stones. These include shock wave lithotripsy (ESWL),transurethral lithotripsy or ureteroscopy (URS), and percutaneousnephrouretero lithotripsy (PCNL) which is sometimes also referred to aspercutaneous nephrolithotomy (PCN).

Shock wave lithotripsy is performed as an extracorporeal treatment. Thistreatment utilizes a machine called a lithotripter that operates bydirecting ultrasonic or shock waves from outside the body, through theskin and tissue, and at the calculi or stones. Repeated shock wavesapply stress to the stones, eventually breaking the individual stonesinto smaller pieces which can more easily pass through the urinary tractin urine. One benefit associated with shock wave lithotripsy is that itis a rather simple procedure. But it has been found that there is arelatively high rate of kidney stone recurrence following shock wavelithotripsy.

Transurethral lithotripsy or ureteroscopy represents one suchalternative form of treatment. This treatment involves the use of smallfiber optic instrument called a ureteroscope which allows access to thecalculus in the ureter or kidney. The ureteroscope can be a rigidureteroscope or more commonly, a flexible ureteroscope. The ureteroscopeallows the medical professional to visualize the stone as theureteroscope moves along the ureter or enters the kidney by way of thebladder and the urethra. Once the calculus is visualized, a basket-likedevice is used to grasp smaller stones and remove them. If the calculusis excessively large to remove as a single piece, it can be broken intoa smaller pieces by using laser energy.

The third form of treatment is percutaneous nephrolithotomy. Thisprocedure is often used with relatively larger calculus that cannot beeffectively treated with either ESWL or URS. Percutaneousnephrolithotomy involves nephrostomy; making an incision at theappropriate location, needling by paracentesis needle, positioning aguide wire through the paracentesis needle's lumen into the kidney underradiographic guidance, and then expanding perforated site. A nephroscopeis then moved into the kidney via nephrostomy to visualize the calculus.Fragmentation of the calculus can be performed using an ultrasonic probeor laser.

Though these procedures have been commonly used, they are susceptible ofcertain short comings. For example, the ESWL procedure results in arelative large number of small calculi or small stones, while otherprocedures require a relatively narrow and long access route or aredifficult to implement due to the inability to accurately capture thestones. In addition to, many crush pieces should be removed one by onein URS and PCNL procedure. The procedure time can also be excessivelylong, and can result in a relatively low “stone free rate.” Therecurrence rate can also be unacceptably high. And the potential patientcomplications (e.g., ischemia of the ureter, obstruction of ureter,back-flow and/or high-stress to the renal pelvis, infection of theurinary tract, and other possible injury) can be undesirably high.

SUMMARY

One aspect of the disclosure here involves a device for retrievingcalculus in a lumen of a living body. The device comprises: an elongatedmember possessing an outer dimension configured to permit the elongatedmember to be positioned in the lumen of the living body, wherein theelongated body includes a lumen possessing an inner surface, an inlet,an outlet and a retrieval space in the lumen. The device also includes asealing member movably positioned in the lumen of the elongated memberto axially move in a distal direction in the lumen toward the inlet andto axially move in a proximal direction in the lumen, wherein thesealing member comprises a first part positioned in the lumen of theelongated member and a second part positioned in the lumen of theelongated member, wherein the second part is positioned distally of thefirst part so that the second part is located axially between the inletand the first part. The second part possesses an outer surface insealing contact with the inner surface of the lumen in the elongatedmember, and the first part and the second part of the sealing member areaxially movable relative to one another in the lumen when the sealingmember is moved in the distal direction so that the first part and thesecond part are axially spaced apart from one another, and also beingaxially movable together as a unit in the lumen when the sealing memberis moved in the proximal direction.

In accordance with another aspect, a device for retrieving calculus in alumen of a living body comprises: an elongated member possessing anouter dimension configured to permit the elongated member to bepositioned in the lumen of the living body, with the elongated bodypossessing a distal end portion and a lumen at the distal end portion ofthe elongated member, and with the lumen in the distal end portion ofthe elongated member possessing an inner surface, wherein the elongatedmember also includes an inlet, an outlet and a retrieval space in thelumen at a position between the inlet and the outlet. A sealing memberis movably positioned in the lumen of the elongated member to axiallymove in a distal direction in the lumen and in a proximal direction inthe lumen, wherein the sealing member possesses an outer peripheralsurface in sealing contact with the inner surface of the lumen in theelongated member. A plunger is connected to the sealing member so thataxial movement of the plunger axially moves the sealing member in thelumen, and the sealing member includes two parts that are separated fromone another to form a divided sealing member when the plunger is movedin the distal direction and that directly contact one another to form anintegrated sealing member when the plunger is moved in the proximaldirection to draw fluid and the calculus into the retrieval space.

Other features and aspects of the calculus retrieving/removing deviceand method disclosed here will become more apparent from the followingdetailed description considered with reference to the accompanyingdrawing figures in which like elements are designated by like referencenumerals.

BRIEF DESCRIPTION OF DRAWINGS

FIG. 1 is a schematic illustration of a calculus removing/retrievingdevice connected to an operation member through the intermediary of aureteroscope

FIG. 2 is a perspective outside view of a calculus removing/retrievingdevice representing another example of the calculus removing/retrievingdevice disclosed here used to carry out an aspect of the disclosedmethod.

FIG. 3A is a perspective view similar to FIG. 2, but illustrating, in anenlarged manner, features associated with the calculusremoving/retrieving device when the sealing member is in an opencondition or state.

FIG. 3B is a perspective view similar to FIG. 3A, but illustrating thecalculus removing/retrieving device when the sealing member is in aclosed condition or state.

FIG. 4 is a perspective view of a calculus removing/retrieving devicerepresenting another example of the calculus removing/retrieving devicedisclosed here, illustrating one operational aspect of the device whenused together with a ureteroscope.

FIG. 5 is a perspective view of the calculus removing/retrieving deviceshown in FIG. 4, illustrating another operational aspect of the devicewhen used together with a ureteroscope.

FIG. 6 is a perspective view of a calculus removing/retrieving devicerepresenting another example of the calculus removing/retrieving devicedisclosed here, illustrating one operational aspect of the device.

FIG. 7 is a perspective view of the calculus removing/retrieving deviceshown in FIG. 6, illustrating a different operational aspect of thedevice.

FIG. 8 is a perspective view of a calculus removing/retrieving devicerepresenting another example of the calculus removing/retrieving devicedisclosed here, illustrating one operational aspect of the device.

FIG. 9 is a perspective view of the calculus removing/retrieving deviceshown in FIG. 8, illustrating a different operational aspect of thedevice.

FIG. 10 is a perspective view of a calculus removing/retrieving devicerepresenting another example of the calculus removing/retrieving devicedisclosed here.

FIG. 11 is a perspective view of the calculus removing/retrieving deviceshown in FIG. 10, illustrating an operational aspect of the device.

FIG. 12 is a perspective view of the calculus removing/retrieving deviceshown in FIG. 10, illustrating different operational aspects of thedevice when used together with a ureteroscope.

FIG. 13 is a perspective view of a calculus removing/retrieving devicerepresenting another example of the calculus removing/retrieving devicedisclosed here.

FIG. 14 is a front end view of the calculus removing/retrieving deviceshown in FIG. 13.

FIGS. 15A-15D are longitudinal cross-sectional views of the calculusremoving/retrieving device shown in FIG. 13 illustrating various aspectsof the operation of the device or method of using the device.

FIG. 16 is a perspective view of a calculus removing/retrieving devicerepresenting another example of the calculus removing/retrieving devicedisclosed here.

FIG. 17A is a perspective view of the calculus removing/retrievingdevice shown in FIG. 16 with the sealing member positioned at the distalend of its movement stroke in the tubular body while the sealing memberis in the folded or open position.

FIG. 17B is a perspective view of the calculus removing/retrievingdevice shown in FIG. 16 with the sealing member positioned at the distalend of its movement stroke in the tubular body while the sealing memberis in the spread or closed position.

FIG. 17C is a perspective view of the calculus removing/retrievingdevice shown in FIG. 16 with the sealing member positioned at theproximal end of its movement stroke in the tubular body while thesealing member is in the closed or spread position.

FIG. 17D is a perspective view of the calculus removing/retrievingdevice shown in FIG. 16 with the sealing member positioned at theproximal end of its movement stroke in the tubular body while thesealing member is in the folded or open position.

FIG. 18A is a perspective view of a portion of another embodiment of thecalculus removing/retrieving device representing a further example ofthe calculus removing/retrieving device disclosed here.

FIG. 18B is a perspective view of the portion of the calculusremoving/retrieving device shown in FIG. 18A while the sealing member ismoved in the rear or proximal direction.

FIG. 18C is a perspective view of the portion of the calculusremoving/retrieving device shown in FIG. 18A while the sealing member ismoved in the forward or distal direction.

DETAILED DESCRIPTION

Set forth below is a detailed description of features and aspects of thecalculus removing/retrieving device and method described here asexamples of the disclosed invention. The methods and devices disclosedhere for removing/retrieving calculus have particularly usefulapplication to retrieve and remove calculus located in the ureter(ureter stones) and calculus located in the renal pelvis (kidneystones), though the methods and evokes are not limited in that regard.

Generally speaking, the calculus removing/retrieving device disclosedhere, as represented by the several embodiments representing examples ofthe inventive calculus removing/retrieving device (and method), isconfigured to be positioned inside a living body at a position adjacentthe location of calculus to be removed from the living body. The calculi(stones) are drawn into the interior of the device by causing a sealingmember positioned within the interior of a body to axially move withinthe interior of the device. As the sealing member moves in the rearwarddirection within the interior of the body, calculus is drawn into theinterior of the body. But during subsequent forward movement of thesealing member, the calculus remains in the interior of the body and isnot ejected out through the inlet.

Turing now to the drawing figures, FIG. 1 illustrates, in a schematicmanner, one version of the calculus removing/retrieving device 50. Asillustrated in FIG. 1, the calculus removing/retrieving device 50 can beused together with an operating member 30 and an ureteroscope 40. Theoperating member 30 is connected to tubing 32 and a manipulation wire 33possessing sufficient flexibility/rigidity characteristics to allow theoperation described below. The manipulation wire 33 passes through thelumen which extends along the tubing 32. The tubing 32 and themanipulation wire extend from the operating member 30, enters an inlet42 of an instrument channel 46 in the ureteroscope 40, passes throughthe ureteroscope 40 and exits at an outlet 45 at the distal end portion44 of the ureteroscope, and is connected to the calculusremoving/retrieving device 50. The distal end portion of the tubing 32is connected to a proximal end surface of the calculusremoving/retrieving device 50. A distal end portion of manipulation wire33 is connected to an elongated plunger 68.

As generally illustrated in FIG. 1, the calculus removing/retrievingdevice 50 includes an elongated member 52. In this illustratedembodiment, the elongated member 52 is a tubular body possessing aninlet 54, an outlet(s) 56, and a lumen extending along the length of thetubular body 52 to define an interior 60 of the tubular body 52. Theinterior (lumen) 60 of the tubular body 452 is surrounded by the innersurface 58 of the tubular body 52. In this embodiment, the outlet 56 isin the form of plural outlets. Also, the outlet(s) is provided in thewall of the tubular body 52, whereas the inlet is provided at the axialend of the tubular body. Further, the outlet(s) 56 is positionedproximally of the inlet 54.

A sealing member 64 is positioned in the interior 60 of the tubular body52 and is configured to axially move within the interior of the tubularbody. The outer peripheral surface of the sealing member 64 contacts theinner surface 58 of the tubular body to provide a seal between thesealing member 64 and the inner surface 58 of the tubular body. That is,the sealing member 64 is substantially in sealing contact with the innersurface 58 of the tubular body 52. The phrase “substantially in sealingcontact” with the inner surface of the tubular body means that thesealing member is in sealing contact with the inner surface, except forsome leakage between the sealing member 64 and the tubular body 52 thatdoes not materially alter the method/operational aspects of the device.A filter 66 is fixed to the sealing member 64. The sealing member 64 andthe filter 66 are connected to each other so that the two move togetherin unison. The sealing member 64 can be in the form of a gasket.

The sealing member 64 is fixed to the elongated plunger 68. That is, thedistal end of the plunger 68 is connected to the sealing member 64 sothat axial movement of the plunger 68 results in axial movement of thesealing member. The plunger 68 also possesses a proximal end connectedto the manipulation wire 33.

By virtue of the construction illustrated in FIG. 1, when the operatingmember 30 is operated by the operator/user (e.g., medical professional)to pull the manipulation wire 33 in the rearward or proximal direction,the plunger 68 and the filter 66 also move in the rearward or proximaldirection within the interior of the tubular body 52 (i.e., to the leftin FIG. 1). When the operating member 30 is operated by theoperator/user to push the manipulation wire 33 in the forward or distaldirection, the sealing member 64 and the filter 66 move together in theforward or distal direction (i.e., to the right in FIG. 1).

The calculus removing/retrieving device 50 further includes a barriermember 70 mounted adjacent the inlet of the tubular body. The barriermember 70 is comprised of several individual barriers or cover parts 72.The barriers 72 are preferably mounted on the distal end of the tubularbody 52 in a manner allowing the barriers to pivot between an openposition of the barriers 72 (open condition of the barrier member 70)which permits calculus and fluid to be drawn through the inlet 54 of thetubular body 52 and into a retrieval space 62 in the interior of thetubular body, and a closed position of the barriers 72 (closed conditionof the barrier member 70) which prevents calculus located in theretrieval space 62 from being discharged out through the inlet 54 pastthe barrier member 70. The retrieval space 62 is located axially betweenthe sealing member 64 and the barrier member 70, and the filter 66 islocated axially between the retrieval space 62 and the sealing member64.

Generally speaking, the operation of the calculus removing/retrievingdevice 50 and associated instrumentation shown in FIG. 1 is as follows.First, the plunger 68 of the calculus removing/retrieving device 50 isconnected to the manipulation wire 33. The proximal end of the tubing 32and the manipulation wire 33 are introduced into the instrument channel46 by way of the outlet 45 at the distal end portion 44 of theureteroscope 40. The tubing 32 and the manipulation wire 33 are movedalong the instrument channel 46 and conveyed out of the channel inlet42, and the proximal end of the tubing 32 and the manipulation wire 33are then connected to the operating member 30. The calculusremoving/retrieving device 50 can then be positioned in the living bodyand advanced to the desired location for removing calculi (stones) inthe living body. As mentioned above, the tubing 32 and the manipulationwire 33 possess sufficient rigidity, yet are sufficiently flexible, toproperly advance the calculus removing/retrieving device 50 along thenecessary part of the living body to position the inlet 54 of thetubular body 52 adjacent the calculus to be retrieved and removed. Forexample, to retrieve and remove calculi or ureter stones in the ureter,the calculus removing/retrieving device can be introduced into theureter by way of the urethra and the bladder. If the calculusremoving/retrieving device is used to retrieve and remove calculi orkidney stones from the renal pelvis, the calculus removing/retrievingdevice can be inserted into the living body, for example by way of theurethra, passed through the bladder and moved along the ureter untilentering the renal pelvis. The calculus removing/retrieving device 50 isthen positioned to locate the inlet 54 of the tubular body 52 at aposition close to or adjacent the calculus to be removed.

When the calculus removing/retrieving device 50 is positioned at thedesired location, the operator/user operates the operating member 30 topull (move) the manipulation wire 33 in the proximal or rearwarddirection. This thus moves the plunger 68 in the proximal or rearwarddirection (i.e., to the left in FIG. 1) which in turn causes the sealingmember 64 as well as the filter 66 to move in the proximal or rearwarddirection. As the sealing member 64 moves in the proximal directionwithin the interior (lumen) of the tubular body, the sealing member 64produces a suction force that draws or sucks stone(s) (calculus orcalculi) and fluid through the inlet 54 and into the retrieval space 62in the interior 60 of the tubular body 52. The filter 66 is specificallysized to permit the passage of fluid, yet prevent the passage ofcalculus that has been retrieved in the retrieval part 62. Thus, whenthe plunger 68 is pulled in the rearward or proximal direction, waterand calculus are sucked into the retrieval space 62 by way of the inlet54, and water is permitted to simultaneously exhaust through the outlet56. The hingedly or pivotally mounted barriers 72 are able to pivotinwardly toward the retrieval space 62 as a result of the suction forcecreated by the rearward movement of the sealing member 64 inside thetubular body 52. This inward pivoting of the barriers 72 opens thebarrier member 70 (barriers 72) to allow calculus and fluid to enter theinterior of the tubular body 52. The barriers 72 (barrier member 70)thus does not present an impediment to drawing calculus I to theretrieval space 62.

As will become more apparent from the description below, the sealingmember 64 can be provided with, for example, through holes so that atleast some of the fluid (water) being sucked into the retrieval space 62by way of the inlet 54 is exhausted through the outlet 56 while thesealing member 64 is being axially moved in the proximal or rearwarddirection.

The operation of the operating member 30 causing the rearward axialmovement of the sealing member 64 in the proximal direction is thenstopped so that the axial movement of the sealing member 64 in therearward or proximal direction ceases. Next, the operating member 30 isoperated to move the manipulation wire 33 in the forward or distaldirection to thus also move the plunger 68, the sealing member 64 andthe filter 66 in the forward or distal direction (i.e., to the right inFIG. 1). The movement of the sealing member 64 in the forward or distaldirection causes the barriers 72 to pivot in a direction away from theinterior of the tubular body so that the barriers 72 (barrier member 70)shifts to the closed positioned generally illustrated in FIG. 1. As willbe described in more detail below in connection with other embodimentsof the calculus removing/retrieving device, the barriers 72 areconfigured so that in the closed position, fluid is permitted to flowfrom the interior 60 (retrieval space 62) of the tubular body 52 throughthe inlet 54 and to the outside of the calculus removing/retrievingdevice, yet calculus that has been sucked into, and is located in, theretrieval space 62 is prevented from flowing outwardly through the inlet54 to the outside of the calculus removing/retrieving device. As thesealing member 64 moves in the forward or distal direction, fluid alsopasses through the filter 66 and the retrieval space 62, and out throughthe inlet 54, but the barriers 72 in the closed position preventcalculus in the retrieval space 62 from flowing out through the inlet54. It is possible to repeat the movement of the sealing member 64 inthe proximal direction and the moving of the sealing member 64 in thedistal direction in a continuous manner to generate fluid flow from theinlet 54 to outlet 45 in the elongated member.

FIGS. 2, 3A and 3B 3 illustrate an embodiment of the calculusremoving/retrieving device 150 representing another example of thecalculus removing/retrieving device and operational method disclosedhere. Features of this embodiment which are similar to featuresdescribed in the earlier embodiment are identified by common referencenumerals, but preceded by a “1”. A detailed description of features inthis embodiment that are similar to features in the earlier embodimentis not repeated, and the following detailed description focusesprimarily on differences between this embodiment and the earlierembodiment.

FIG. 2 illustrates that the calculus removing/retrieving device 150includes an elongated member or tubular body 152 having a generallyrounded triangular exterior shape as seen in a cross sectionperpendicular to the central longitudinal axis of the tubular body 152.As illustrated in FIG. 3A, this embodiment of the calculusremoving/retrieving device 150 includes a multi-part sealing member 164.That is, the sealing member 164 is comprised of a first part 176 and asecond part 178. The distal end of the plunger 168 is fixed to thesecond part 178 of the sealing member 164, and the first part 176 of thesealing member 164 is slidably mounted on the plunger 168 so that thefirst and second parts 176, 178 of the sealing member 164 are relativelyaxially movable, over a limited axial distance or axial extent, relativeto one another. The first part 176 of the sealing member 164 includes anelongated slot 180 extending along the longitudinal extent of the firstpart 176. The first part 176 of the sealing member 164 also includesseveral upstanding cover elements 182. The cover elements 182 are fixedto the first part 176 of the sealing member 164 so that the coverelements 182 and the first part 176 of the sealing member 164 movetogether as a unit.

The second part 178 of the sealing member 164 possesses an outer surface177 that matches the shape of the inner surface 158 of the tubular body152. The outer surface 177 of the second part 178 thus contacts theinner surface 158 of the tubular body in a sealing manner. That is, thesecond part 178 of the sealing member 164, which can be in the form of agasket, forms a seal with the inner surface 158 of the tubular body 152.The second part 178 of the sealing member 164 includes one or morespaced apart through holes 186. In the illustrated embodiment, thesecond part 178 of the sealing member 164 includes two through holes186. The through hole(s) 186 preferably possess a shape that matches theouter shape of the upstanding cover elements 182. As described in moredetail below, this allows the cover elements 182 to close, for exampleby covering or being positioned in, the through holes 186 in the secondpart 178 of the sealing member 164. FIG. 3B illustrates an example inwhich the cover elements 182 are positioned in the through holes 186 inthe second part 178 of the sealing member 164 so that the sealing member164 is in a closed state or condition.

A filter 166 is also fixed to the second part 178 of the sealing member164 so that the filter 166 and the second part 178 of the sealing member164 move together as a unit. The filter 166 is positioned axiallybetween the second part 178 of the sealing member 164 and the retrievalspace 162 in which calculus is collected (held) during the calculusretrieval operation as will be described in more detail below.

The plunger 168 includes an upstanding pin 184 that is positioned in theelongated slot 180 in the second part 176 of the sealing member 164. Asdescribed above, the first part 176 of the sealing member 164 is movablealong the plunger 168 so that the first part 176 of the sealing member164 and the second part 178 of the sealing member 164 are relativelyaxially movable. The tube 132 shown in FIG. 2 is connected to the closedend of the tubular body 152 so that a liquid-tight arrangement exists inwhich fluid inside the tubular housing does not leak outside the tubularbody by way of the tube 132.

FIG. 3A illustrates the first part 176 of the sealing member 164 at aposition in which the first part 176 of the sealing member 164 isaxially spaced farthest from the second part 178 of the sealing member164. In this position, the upstanding pin 184 on the plunger 168 islocated at the forward-most end of the elongated slot 180, and the coverelements 182 on the first part 176 of the sealing member 164 are spacedapart from the through holes 186 in the second part 178 of the sealingmember 164. The through holes 186 in the second part 178 of the sealingmember 164 are thus open. The first and second parts 176, 178 of thesealing member 164 are axially relatively movable towards one anotheruntil the cover elements 182 on the first part 176 of the sealing member164 cover or, as illustrated in FIG. 3B, are positioned in the throughholes 186 in the second part 178 of the sealing member 164.

When the first and second parts are positioned relative to one anotherin the manner illustrated in FIG. 3A, fluid is able to flow through thethrough holes 186. On the other hand, when the cover elements 182 arepositioned in the through holes 186 as shown in FIG. 3B, the coverelements 182 cover the through holes 186 and prevent fluid from passingthrough the second part 178.

The operation of the embodiment illustrated in FIGS. 2, 3A and 3B is asfollows. The calculus removing/retrieving device 150 is connected to anoperating member, for example the operating member 30 shown in FIG. 1.The calculus removing/retrieving device 50 is then inserted into theliving body and advanced to the location of the calculus to be retrievedand removed. This can be accomplished in the manner described above.When the inlet 156 of the tubular body 152 is positioned adjacent thecalculus to be retrieved and removed, and with sealing member 164 of thecalculus removing/retrieving device 50 arranged in a manner like thatshown in FIG. 3A, the plunger 168 is axially moved in the rearward orproximal direction (by operating the operating member 30 which pulls themanipulation wire 33 and rearwardly moves the plunger 168). The rearwardmovement of the plunger 168 causes the second part 178 of the sealingmember 164 to also move in the rearward or proximal direction, togetherwith the filter 166. Initially, in a divided state of the sealing member164, the second part 178 moves relative to the first part 176 of thesealing member 164, and the pin 184 moves rearwardly in the slot 180 sothat the second part 178 approaches the first part 176. It is possibleto hold the first part 176 of the sealing member 164 so that thisrelative movement occurs. The first part 176 and the plunger 168 canalso be configured so that the friction between the first part 176 andthe plunger 168 is relatively low so that such holding of the first part176 may not be necessary. Also, the retrieval space 162 of the tubularbody 152 contains, or is filled with, fluid (water/saline) and so boththe first part 176 and the second part 178 receive the drag (resistance)of the fluid against moving. This resistance can function as a holdingmechanism.

After the second part 178 of the sealing member 164 has moved relativeto the first part 176 of the sealing member 164 over a first axialdistance generally equal to the length of the elongated slot 180 in thefirst part 176 of the sealing member 164, the pin 184 contacts theproximal end of the slot 180. At about the same time, the upstandingcover elements 182 are positioned in or cover the through openings 186in the second part 178 of the sealing member 164 as shown in FIG. 3B.When the sealing member 164 is in this integrated state in which thefirst and second parts 176, 178 of the sealing member move together,further rearward movement of the plunger 168 causes rearward movement ofthe first part 176 of the sealing member 164, the second part 178 of thesealing member 164 and the filter 166. The first part 176 of the sealingmember 164, the second part 178 of the sealing member 164 and the filter166 move together over a second axial distance until the first part 176of the sealing member 164, the second part 178 of the sealing member 164and the filter 166 reach the limit if the rearward movement. Because thesecond part 178 is in sealing contact with the inner surface 158 of thetubular body 152, the rearward movement of the second part 178 (whilethe through holes 186 in the second part 178 of the sealing member 164are closed) causes calculus and fluid to be sucked into the interior 160of the tubular body 152 by way of the inlet 154 so that the calculus(and fluid) is located in the retrieval space 162. At approximately thesame time discharging of the fluid that has been introduced into thespace between the proximal surface of the sealing member 164 and theclosed end of the tubular body 152 by way of the outlet occurs, if thespace between the proximal surface of the sealing member 164 and theclosed end of the tubular body 152 has been filled by the fluid to someextent. The calculus removing/retrieving device 150 can be provided witha stop (e.g., similar to the push member 569 shown in FIGS. 14 and 15and described below) to limit the rearward movement.

After calculus has been drawn into or sucked into the interior 160 ofthe tubular body 152 and the rearward movement of the plunger (as wellas the first part 176 of the sealing member 164, the second part 178 ofthe sealing member 164 and the filter 166) is stopped, the plunger 168is axially moved in the forward or distal direction (i.e., to the rightin FIG. 3B). During a first part of the movement of the plunger in theaxial direction (i.e., until the upstanding pin 184 on the plunger 168contacts the distal or forward end of the elongated slot 180 in thesecond part 176 of the sealing member 164), the second part 178 of thesealing member 164 moves relative to and away from the first part 176 ofthe sealing member 164. The cover parts 182 thus move away from thethrough holes 186 in the second part 178 of the sealing member 164 sothat the through holes 186 become uncovered (i.e., are once again open).During this first part of the movement of the plunger until theupstanding pin 184 on the plunger 168 contacts the distal or forward endof the elongated slot 180 in the second part 176 of the sealing member164, the second part 178 of the sealing member 164 moves the first axialdistance relative to first part 176 of the sealing member 164.

When the upstanding pin 184 on the plunger 168 contacts the distal orforward end of the elongated slot 180 in the second part 176, furtheraxial movement of the plunger 168 in the forward or distal directioncauses the second part 178 of the sealing member 164, the first part 176of the sealing member 164 and the filter 166 to axially move together inthe forward or distal direction over a second axial distance until thelimit of the forward movement is reached. The calculusremoving/retrieving device 150 can be provided with a stop (e.g.,similar to the stop 580 shown in FIG. 14 and described below) to limitthe forward movement. When the plunger 168 is pushed and axially movedin the forward or distal direction, the plunger does not create bothsuction and exhaust, but rather only the axial position of the plungerchanges. Fluid in the retrieval part or retrieval space 162 is able toflow through the filter 166, flow past the through holes 186 in thesecond part 178 and reach the space between the proximal surface of thesealing member 164 and the closed end of the tubular body 152. Whilefluid is able to flow through the filter 166, the filter is specificallyconfigured to prevent the passage of the calculus in the retrieval space162. The calculus is thus retained in the retrieval space 162. In thisillustrated and disclosed embodiment, when the sealing member 164 is inthe open state or condition, fluid is not exhausted through the outlet.When the sealing member 164 is in the closed state or condition, fluidpresent in the space between the closed sealing member and the closedend of the tubular body (i.e., the closed left end of the tubular bodyas seen with reference to FIG. 2) can exhaust or flow out through theoutlet(s) 156.

The plunger is then once again moved rearwardly in the proximaldirection and the operation described above is repeated. This forwardand rearward movement is repeated to continue drawing calculus into theinterior of the tubular body to be retained in the retrieval space 162.Once the retrieval operation is complete, the calculusremoving/retrieving device 150 is pulled out of the living body with theretrieved calculus remaining in the retrieval space 162.

The embodiment of the calculus removing/retrieving device shown in FIGS.2, 3A and 3B does not specifically illustrate a barrier member at theinlet 156 of the tubular body. It is possible to use a barrier member,such as the barrier member shown in FIG. 1 and described above, or oneof the barrier members described below.

FIGS. 4 and 5 illustrate a variation on the embodiment illustrated inFIGS. 1-3B. In this embodiment, the tube 132 is rotationally fixedrelative to the elongated tubular body 152. As a result, the tube 132and the tubular body 152 rotate together as a unit when the tube 132 isrotated. This is beneficial from the following standpoint.

As illustrated in FIG. 4, the ureteroscope includes an objective lens 45providing a field of view 47 (generally indicated in dotted outline inFIG. 4) during the calculus removing/retrieving operation. The tube 132is offset from the central axis of the elongated tubular body 152. Thatis, the central axis of the tube 132 and the central axis of the tubularbody 152 are not coaxial. Further, the central axis of the instrumentchannel 46 in the ureteroscope 40 is radially offset from the centralaxis of the distal end portion 44 of the ureteroscope 40. By virtue ofthis construction, it is possible to maintain visibility (i.e., tomaintain unobstructed visibility or view) of the portion of the livingbody in front of the tubular body 152 during the calculus removingoperation.

FIG. 4 illustrates the position or orientation of the tubular body 152relative to the ureteroscope 40 during the calculus retrieval operation,while FIG. 5 illustrates the position or orientation of the tubular body152 relative to the ureteroscope 40 during insertion of the calculusremoving/retrieving device into the living body (lumen of the livingbody) and during withdrawal of the calculus removing/retrieving devicefrom the living body (lumen of the living body). As the tubular body 152is being introduced into the living body (into the lumen of the livingbody) and is being advanced in the living body (along the lumen of theliving body) to the position in the living body at which calculus to beretrieved and removed is located, the tubular body 152 is positioned ororiented relative to the ureteroscope 40 in the manner illustrated inFIG. 5. In this position, the central axis of the tubular body 152 andthe central axis of the ureteroscope (the distal portion of theureteroscope 40 adjoining the tubular body 52) are aligned or arecoaxial. This provides a relatively small and streamlined outerconfiguration that facilitates the introduction and movement of thetubular body and ureteroscope 40 into and long the living body (lumen ofthe living body).

After the tubular body 152 is located in the living body (lumen of theliving body) at the position in the living body (lumen of the livingbody) at which calculus to be retrieved and removed is located, thetubular body 152 is rotated relative to the distal portion of theureteroscope 40 in the direction indicated by the arrow in FIG. 4 sothat the tubular body 152 rotates from the position shown in FIG. 5 tothe position illustrated in FIG. 4. In this position shown in FIG. 4,the central axis of the tubular body 152 and the central axis of theureteroscope (the distal portion of the ureteroscope 40 adjoining thetubular body 52) are not aligned (i.e., are not coaxial). With thetubular body 152 positioned in the manner shown in FIG. 4, the calculusretrieval operation can be carried out without obstructing the field ofview 47 of the objective lens 45. After the calculus retrieval operationis completed as described earlier, the tubular body 152 is rotatedrelative to the distal portion of the ureteroscope 40 in the directionindicated by the arrow in FIG. 5 so that the central axis of theelongated body 152 and the central axis of the distal end portion of theureteroscope 40 are once again aligned or coaxial with one another. Thisallows the tubular body 152 and the ureteroscope 40 to be more easilyremoved from the living body.

FIGS. 6 and 7 illustrate another embodiment of the calculusremoving/retrieving device representing another example of the calculusremoving/retrieving device and operational method disclosed here.Features in this embodiment which are similar to features described inearlier embodiments are identified by common referenced numerals, butpreceded by a “2”. A detailed description of features in this embodimentthat are similar to features in the earlier embodiment is not repeated.The following detailed description focuses primarily on differencesbetween this embodiment and the earlier embodiment. FIGS. 6 and 7illustrate another version of a barrier member that can be provided atthe inlet of the tubular body.

FIGS. 6 and 7 illustrate a calculus removing/retrieving device similarto the one shown in FIGS. 2 and 3, except that the calculusremoving/retrieving device 250 shown in FIGS. 6 and 7 includes a barriermember 270. That is, the barrier member 270 illustrated in FIGS. 6 and 7can be sued with the calculus removing/retrieving device 150 illustratedin FIGS. 2 and 3. The barrier member 270 illustrated in FIGS. 6 and 7includes several spaced apart barriers 272 that are fixed to the filter266 so that the filter 266 and the barriers 272 move together as a unit.Because the filter 266 is fixed to a part of the sealing member (e.g.,the second part 178 of the sealing member 164 shown in FIG. 3), thebarrier member 270 also moves together with the sealing member.

The barrier member 270 also includes a barrier holder 271. The barrierholder 271 is a plate-shaped element fixed to the interior of thetubular body 252. In the illustrated embodiment, the barrier holder 271is fixed to the bottom surface of the tubular body 252. The barriers 272are elongated rod-shaped elements that pass through respective throughpassages (e.g., holes or grooves) in the barrier holder 271. Thebarriers 272 are movable relative to the barrier holder 271.

The barriers 272 are configured such that in the absence of an appliedforce (internal or external), the barriers 272 exhibit the curved shapeor configuration shown in FIG. 7. That is, when a sufficient portion ofthe length of the barriers 272 extends distally beyond the distal end ofthe barrier holder 271, the barriers 272 naturally or automaticallycurve upward to function as a barrier across the inlet 254 of thetubular body 252. On the other hand, when the barriers 272 are movedrearwardly in the proximal direction so that the naturally curved partof the barriers 272 is positioned in the barrier holder 271 as shown inFIG. 6, the barriers 272 deviate from their natural curved state andbecome straight by virtue force applied by the barrier holder 271. Inthis state or position shown in FIG. 6, the barriers 272 do not crossthe inlet and do not serve as a barrier for the inlet.

The material forming the barriers 272 can be shape memory metal (e.g.,NiTi wire) so that the barriers 272 naturally exhibit the curved shapeor configuration shown in FIG. 7, yet are straightened when movedrearwardly inside the barrier holder 271 as shown in FIG. 6. It is alsopossible to use other spring-like material that tends to exhibit anatural curved shape or configuration when a force (external or internalforce) is not applied to the barriers 272.

During use, when the sealing member 164 (first and second parts 176, 178of the sealing member 164) is positioned in the manner shown in FIG. 3,the barriers 272 are positioned in the manner illustrated in FIG. 6. Asthe plunger 168 is moved in the forward or distal direction, thebarriers 272 move in the forward or distal direction so that thebarriers 272 extend distally beyond the distal end of the barrier holder271. During this forward movement of the barriers 272, the barriers 272curve in a direction causing the barriers 272 to cross the inlet 254.The barriers 272 are thus moved to the position shown in FIG. 7. In thisFIG. 7 position, the barriers 272 prevent calculus which has previouslybeen drawn into the retrieval space 262 from being ejected out throughthe inlet 254.

When the plunger and the sealing member are then moved in the rearwardor proximal direction to draw or suck calculus into the interior of theelongated body, the barriers 272 are also moved in the same direction.The barriers 272 are thus pulled back into the barrier holder 271 asshown in FIG. 6 so that the inlet 254 is once again open, thus allowingcalculus to be drawn or sucked into the interior of the tubular body252.

FIGS. 8 and 9 illustrate a further embodiment of the calculusremoving/retrieving device representing another example of the calculusremoving/retrieving device and operational method disclosed here.Features in this embodiment which are similar to features described inearlier embodiments are identified by common referenced numerals, butpreceded by a “3”. A detailed description of features in this embodimentthat are similar to features in the earlier embodiment is not repeated.The following detailed description focuses primarily on differencesbetween this embodiment and earlier embodiments. FIGS. 8 and 9illustrate another version of a barrier member that can be provided atthe inlet of the tubular body.

In this embodiment shown in FIGS. 8 and 9, the barrier member 370 is ahinged barrier 372 that is hinged to the bottom of the tubular body 352.That is, the barrier 372 is connected to the bottom of the tubular body352 at a hinge. The barrier member 370 also includes a barrier holder371 that is fixed to the filter 366 so that the filter 366 and thebarrier holder 371 move together as a unit. Because the filter 366 isfixed to a part of the sealing member (e.g., the second part 378 of thesealing member 364 schematically depicted in FIG. 3), the barrier holder371 also moves together with the sealing member. The distal end of thebarrier holder 371 includes an enlarged stop 371′ that serves as a stopto maintain the barrier 372 in the upright position shown in FIG. 8 whenthe stop 371′ is pressing against (contacting) the barrier 372. In theillustrated embodiment, the enlarged stop 371′ possesses a planarforward facing front surface that contacts the barrier 372.

The barrier 372 can be in the form of a wall that covers a sufficientlylarge portion of the inlet that calculus located in the retrieval space362 is unable to flow out through the inlet 354 when the barrier is inthe upright position shown in FIG. 8. Alternatively, the barrier 372 canbe in the form of several spaced apart and hingedly connected uprightwall portions that are each held in the upright position by a respectivebarrier holder 371 and stop 371′. In this alternative, the severalspaced apart barriers would be configured (sized) to cover asufficiently large portion of the inlet 354 that calculus located in theretrieval space 362 is unable to flow out through the inlet 354 when thebarriers are in the upright position shown in FIG. 8.

When the filter 366 and the second part 378 of the sealing member 364are positioned at the forward-most or distal-most position shown in FIG.8, the stop 371′ at the distal end of the barrier holder 371 actsagainst the barrier 372 to keep the barrier 372 in the upright position.In this position, the barrier 372 extends across the inlet 354 of thetubular body to close the inlet 354. When the plunger 368 is moved inthe rearward or proximal direction (to the left in FIGS. 8 and 9) tomove the filter 366 and the sealing member 364 in the rearward orproximal direction, the barrier holder 371 also moves in the rearward orproximal direction. The barrier(s) 372 is thus no longer held in theupright position by the stop 371′. As the sealing member 364 is moved inthe rearward or proximal direction to draw calculus and fluid into theinterior of the tubular member 352, the incoming calculus and fluidapplies a force to the barrier 372 causing the barrier to fall or rotatein the direction indicated by the arrow in FIG. 9 so that the barrier272 overlies the bottom of the tubular body 352 as illustrated in FIG.9.

FIGS. 10-12 illustrate an embodiment of the calculus removing/retrievingdevice representing another example of the calculus removing/retrievingdevice and operational method disclosed here. Features of thisembodiment which are similar to features described in the earlierembodiment are identified by common reference numerals, but preceded bya “4”. A detailed description of features in this embodiment that aresimilar to features in the earlier embodiment is not repeated, and thefollowing detailed description focuses primarily on differences betweenthis embodiment and the earlier embodiment.

This embodiment shown in FIGS. 10-12 is similar to the embodimentillustrated in FIGS. 8 and 9, except that the configuration of thebarrier member 470 is different. The barrier member 470 shown in FIGS.10-12 includes a barrier 472 hingedly connected to the bottom wall ofthe tubular body and positioned at the inlet 454 of the tubular body452. The barrier 472 includes a through opening 472′. The barrier member470 also includes a barrier holder 471 that is fixed to the filter sothat the barrier holder 471 moves together with the filter (and thesecond part of the sealing member as well as the plunger). The barriermember 470 extends forwardly in the distal direction towards the barrier472. A stop 471′ is positioned at the distal end of the barrier holder471.

In this embodiment illustrated in FIGS. 10-12, the stop 471′ is rounded.In addition, the barrier holder 471 is positioned in aligned relation tothe through opening 472′ in the barrier 472, considered with referenceto the width-wise direction (i.e., the width-wise dimension indicated as“X” in FIG. 10). In the illustrated embodiment, the barrier holder 471and the through opening 472′ are both positioned generally in the centerof the barrier 472 with reference to the width-wise dimension indicatedX.

When the sealing member is in the forward most or distal-most position,the stop 471′ contacts the barrier 472 to maintain the barrier 472 inthe upright position as illustrated in FIG. 11. In this position, thestop 471′ is positioned below the through opening 472′. As illustratedin FIG. 11, the surface of the barrier 472 facing towards the stop 471′possesses a concavo-convex shape. The concavo-convex shape includes aportion 472″ possessing a concave shape and a portion 472′″ possessing aconvex shape. The concave portion 472″ receives the stop 471′ when thesealing member is in the forward-most or distal-most position with thestop 471′ in contact with the barrier 472.

When the sealing assembly is positioned in the forward-most ordistal-most position so that the barrier 472 is upright and the stop471′ is pushing-on and contacting the barrier 472, movement of theplunger and the sealing assembly in the rear or proximal directioncauses the barrier holder 471 and the stop 471′ to also move rearwardlyor in the proximal direction. As discussed above, the rearward movementof the sealing member draws fluid and calculus into the interior of thetubular body through the inlet 454. This inflow of fluid and calculuscauses the barrier 472 to rotate or pivot to the left in FIG. 11 so thatthe barrier 472 falls down to the position show in FIG. 12. In thisposition, the barrier 472 overlies the bottom of the tubular body 452 asillustrated in FIG. 12, and the inlet 454 of the tubular body 452 isopen. In this position, the stop 471′ is located in the window 472′ asdepicted in FIG. 12. The through opening or window 472′ in the barrier472 can be appropriately dimensioned to accommodate the maximum rearwardmovement of the stop 471′ (sealing member/plunger) in the proximatedirection. Aligning the stop 471′ with the through opening 472′ allowsthe enlarged stop 471′ to be located in the through opening 472′ whenthe barrier 472 is pivoted to the position shown in FIG. 12. This allowsthe barrier 472 to pivot further towards the bottom of the tubular body452 than would otherwise be the case if the pivoting movement of thebarrier 472 was limited by the stop 471′. In addition, this aligningenables the barrier 472 to open by a shorter stroke of stop 471 than isthe case with the no-window type device (i.e., FIGS. 8 and 9). The shortstroke helps improve and maximize the calculus removing/retrievingefficiency. Through a single pulling of the stop 471, the time requiredfor opening the barrier 472 become less than the time for suction.

When the sealing member is moved in the forward or distal direction, thebarrier holder 471 also moves in the forward or distal direction. Thiscauses the stop 471′ to push on the barrier 472 to raise the barrier 472from the folded position (open state) illustrated in FIG. 12 to theupright position (closed state) illustrated in FIG. 11 in which thebarrier 472 closes the inlet 452 so that calculus retrieved and held inthe retrieval space 462 of the tubular body 452 does not flow outthrough the inlet 454. The rounded or curved shape of the stop 471′ andthe convex shape of the portion 472′″ interact with one another tofacilitate lifting of the barrier 472 from the folded position shown inFIG. 12 to the upright position illustrated in FIG. 11 when the barrierholder 471 and the stop 471′ are moved in the forward or distaldirection during movement of the plunger in the forward or distaldirection. The manner of operation of this embodiment is similar to thatdescribed above and so such description is not repeated.

As discussed above, the window or through opening 472′ in the barrier472 shown in FIGS. 10-12 allows the barrier 472 to be further foldedaway from the inlet 454 than would otherwise be the case in the absenceof the window or through opening 472′. The through opening 472′ enablesthe barrier 472 to open by a shorter stroke of the stop 471 than is thecase with the no-window type device (i.e., FIGS. 8 and 9). The shorterstroke imparts calculus removing/retrieving efficiency to the device.Through a single pulling of the stop 471, the time required for theopening the barrier 472 is less than the time for suction. The throughopening 472′ also allows fluid in the retrieval space 462 to flow outwhen the barrier holder 471 and the stop 471′ are moved in the forwardor distal direction.

FIGS. 13-15 illustrate an additional embodiment of the calculusremoving/retrieving device representing another example of the calculusremoving/retrieving device and operational method disclosed here.Features of this embodiment which are similar to features described inthe earlier embodiment are identified by common reference numerals, butpreceded by a “5”. A detailed description of features in this embodimentthat are similar to features in the earlier embodiment is not repeated,and the following detailed description focuses primarily on differencesbetween this embodiment and the earlier embodiment.

Referring to FIG. 13, the calculus removing/retrieving device 550includes a tubular body or elongated member 552 having an inlet 554 andan outlet 556. In the illustrated embodiment, the tubular body 552 isprovided with a plurality of outlets 556. Also, in this illustratedembodiment of the calculus removing/retrieving device, the tubular bodyis a circular cylindrical tubular body, though it is to be understoodthat the tubular body can have tubular shapes other than a tubularcylindrical shape. A plunger 568 is connected to a sealing member 564,and the sealing member 564 is comprised of a first part 576 and a secondpart 578. The outer circumferential (annular) surface of the sealingmember 564 (i.e., the outer circumferential surface of the first part576 and the outer circumferential surface of the second part 578)contacts the inner surface of the tubular body 552 so that a seal isformed. A filter 566 is fixed to the second part 578 so that the secondpart 578 and the filter 566 move together as a unit. As illustrated inFIGS. 13 and 15A-15D, the filter 566 includes a plurality of throughholes 567, and the second part 578 of the sealing member 564 includes acentrally located through hole 579 that communicates with the throughholes 567 in the filter 566. So long as the through hole 579 in thesecond part 578 remains open, fluid flowing through the through holes567 in the filter pass through the through hole 579 in the second part578 of the sealing member.

The first part 576 of the sealing member 564 includes a centrallylocated protrusion or projection, and a plurality of through holes 577that are circumferentially spaced apart at positions radially outwardlyof the projection 575. The first part 576 of the sealing member 564 ismovable relative to the second part 578 (and relative to the filter 566)of the sealing member 564. In this way, the first part 576 and thesecond part 578 can be axially spaced apart from one another in themanner shown in FIG. 13 so that the central projection 575 of the firstpart 576 of the sealing member 564 is not positioned in (i.e., isaxially spaced from) the through hole 579 of the second part 578 of thesealing member 564 as shown in FIGS. 15A and 15D. In this state (openstate), fluid is able to pass through the through holes 567 in thefilter 566, pass through the through hole 579 in the second part 578 ofthe sealing member 564 and pass through the through holes 577 in thefirst part 576 of the sealing member 564 so that strong fluid flow isnot generated enough to suck the stones and to exhaust the stonesgathered into retrieval space 562. In this open state of the sealingmember 564, fluid is not exhausted through the outlet(s) 556. On theother hand, the first part 576 and the second part 578 of the sealingmember 564 can be relatively axially moved so that the facing surfacesof the first and second parts 576, 578 directly contact one another asillustrated in FIGS. 15B and 15C. In this state, the projection 575 onthe first part 576 is positioned in the through hole 579 in the secondpart 578, and so the fluid path through the second part 578 of thesealing member 564 is closed off. In this closed position of the sealingmember 564, fluid flows into the retrieval space 562 by way of the inlet554, and fluid between the sealing member 564 and the closed end of thetubular housing 552 exits through the outlet(s) 556.

The plunger 568 passes freely through the first part 576 of the sealingmember 564 and is fixed to the second part 578 of the sealing member564. The plunger 568 and the second part 578 of the seal member thusmove together as a unit. A push member 569 is fixed to the plunger 568so that the plunger 568 and the push member 569 move together as a unit.With this construction, beginning from the position illustrated in FIG.13 and FIG. 15A, when the plunger 568 is moved in the proximal orrearward direction represented by the arrow in FIG. 15A (i.e., to theleft in FIGS. 13 and 15A), the second part 578 of the sealing member 564(and the filter 566) axially move relative to and towards the first part576 of the sealing member 564. The first and second parts 576, 578 ofthe sealing member 564 will then contact each other as illustrated inFIG. 15B, and so further rearward pulling of the plunger 568 causes theentire sealing member 564 (i.e., the first part 576 and the second part578), as well as the filter 566, to move rearwardly in the proximaldirection represented by the arrow in FIG. 15B (i.e., to the left inFIGS. 13 and 15B). Then the sealing member 564 reaches the end of itsaxial movement stroke in the proximal direction such as shown in FIG.15C. After that, for the purpose of obtaining the next suction fluidflow, the plunger 568 is moved in the forward or distal axial directionrepresented by the arrow in FIG. 15D. During the initial part of thisforward movement of the plunger, the second part 578 of the sealingmember 564 moves relative to and away from the first part 576 of thesealing member 564 so that the projection 575 on the first part 576 ofthe sealing member 564 moves out of the through hole 579 in the secondpart 578 of the sealing member 564. The first and second parts 576, 578of the sealing member 564 are thus axially spaced apart from oneanother. When the push member 569 contacts the first part 576 of thesealing member 564, the first and second parts 576, 578 of the sealingmember 564, as well as the filter 566, move together in the forward ordistal direction, and the axial spacing between the first and secondparts 576, 578 of the sealing member 564 is maintained until the plungerreaches the end of its forward axial movement stroke. The forward axialmovement stroke is limited by the contact between an elongated slot 580and a proximal end surface (closed end surface) of the tubular body 552.The position of the slot 580 along the plunger 568 defines the limit ofthe forward axial movement. It is possible to configure the slot580/plunger 568 so that the position of the slot 580 along the plunger568 is adjustable, thus allowing adjustment of the forward axialmovement limit.

The calculus removing/retrieving device 550 shown in FIG. 13 furtherincludes a barrier member 570. The barrier member 570 includes aplurality of barriers or cover members 572. Each of the cover members572 includes a pair of disks 573, 573 that are connected in a hingedmanner to each other in a hinged manner. This hinged connection allowsthe disks 573, 573 to be positioned in a relative overlappingarrangement such as shown in FIG. 15A and in a spread out manner. Eachof the barriers or covers 572 further includes a connector 571connecting each respective barrier 572 to the filter 566 as illustratedin FIGS. 15A-15D. When the plunger 568 is axially moved in the proximaldirection to also axially move the filter 566 (and the second part 578of the sealing member 564) in the proximal direction away from the inlet554, the barrier member 570 shifts from the position illustrated in FIG.15A in which the barrier member 570 is closed to the positionillustrated in FIG. 15C in which the barrier member 570 is opened.

As described above, each of the barriers 572 includes a pair of coverelements or disks 573, 573. The disk 573 in each pair which is closestto the inlet 554 (farthest from the filter 566) is preferably connectedto the outer end or rim of the tubular body 552. Also, when the filtermoves in the forward or distal direction after having been pulledrearwardly, the barrier member 570 shifts from the open configurationillustrated in FIG. 15D to the closed configuration illustrated in FIG.15A.

The operation of the embodiment of the calculus removing/retrievingdevice 550 shown in FIGS. 13, 14 and 15A-15D is as follows. The deviceis positioned in the living body in the manner described above so thatthe inlet 554 of the tubular body 552 is located adjacent calculus to beretrieved and removed from the living body. At this time, the calculusremoving/retrieving device 550 is in the operational condition shown inFIG. 15A. The plunger 568 is then pulled rearwardly in the proximaldirection indicated by the arrow in FIG. 15A to axially move the filter566 and the second part 578 of the sealing member 564 relative to andtowards the first part 576 of the sealing member 564. During thisrelative movement, the first part 576 of the sealing member 564preferably does not move. The second part 578 of the sealing member 564eventually contacts the first part 576 of the sealing member 564 asillustrated in FIG. 15B. When this occurs, the projection 575 on thefirst part 576 of the sealing member 564 is positioned in the centralthrough hole 579 in the second part 578 and so fluid flow through thefirst and second parts 576, 578 of the sealing member 564 is blocked orprevented. During this movement of the second part 578 of the sealingmember 564 and the filter 566 in the rearward or proximal direction(i.e., from the position shown in FIG. 15A to the position shown in FIG.15B), the barrier member 570 begins to shift from the closed positionshown in FIG. 15A toward the open position shown in FIG. 15B. Thus,between the position illustrated in FIG. 15A and the positionillustrated in FIG. 15B, the second part 578 of the sealing member 564moves relative to the first part 576 of the sealing member 564 over afirst axial distance.

Further axial movement of the plunger 568 in the rearward or proximaldirection causes the sealing assembly 564 (i.e., the first part 576 andthe second part 578) as well as the filter 566 to also move in therearward or proximal direction. This causes the barrier member 570 to beshifted to the open condition illustrated in FIG. 15C. During thisrearward movement of the sealing member 564, the passage of fluidthrough the sealing member 564 is blocked, so that the calculusremoving/retrieving force is generated and calculus and fluid are drawninto the retrieving space 562 in the interior of the tubular body 552 byway of the inlet 554. Almost at the same time, the fluid in the spacebetween the sealing member 564 and the inner bottom (closed end) of thetubular body 552 is exhausted by way of the outlet(s) 556. The volume ofexhausted fluid is almost same as the migration volume of the first part576. The calculus is able to enter the interior of the tubular body 552because the barrier member 570 has shifted to the open position shown inFIG. 15C. FIG. 15C illustrates the calculus removing/retrieving device550 after the plunger 568 has reached the end of its rearward axialmovement in the proximal direction. Between the position illustrated inFIG. 15B and the position illustrated in FIG. 15C, the first and secondparts 576, 578 of the sealing member 564 axially move a second axialdistance that is greater than the first axial distance discussed above.

After the sealing member 564 reaches the end of its rearward movement inthe proximal direction, the plunger 568 is pushed in the forward ordistal direction. This causes the filter 566 and the second part 578 ofthe sealing member 564 to axially move together in the forward or distaldirection so that the filter 566 and the second part 578 of the sealingmember 564 move together from the position shown in FIG. 15C toward theposition shown in FIG. 15D. During this movement, the barrier member 570begins to shift from the open position shown in FIG. 15C, to theposition shown in FIG. 15D and toward the closed position shown in FIG.15A. During the initial movement of the plunger 568 in the forward ordistal direction, the second part 578 of the sealing member 564 and thefilter 566 move relative to and away from first part 576 of the sealingmember 564 so that the second part 578 of the sealing member 564 becomeseparated from the first part 576 of the sealing member 564. Theprojection 575 on the first part 576 of the sealing member 564 thusmoves out of through hole 579 in the second part 578 of the sealingmember 564 so that fluid is allowed to flow through the filter 566,through the through hole 579 in the second part 578 and through thethrough holes 577 in the first part 576 of the sealing member 564.Further forward movement of the plunger 568 causes the push member 569to contact the first part 576 of the sealing member 564 as illustratedin FIG. 15D. Between the position illustrated in FIG. 15C and theposition illustrated in FIG. 15D, the second part 578 of the sealingmember 564 moves relative to the first part 576 of the sealing member564 over a first axial distance that is the same as the first axialdistance discussed above (i.e., the first axial distance between theposition in FIG. 15A and the position in FIG. 15B).

As the plunger 568 moves in the forward direction, relatively weak fluidflow is generated to flow out through the inlet 564. But because thebarrier member 570 is shifting toward the closed position, calculus thathas been retrieved in the retrieval space 562 and that is held in theretrieval space does not flow out through the inlet 554 because thebarrier member 570 blocks the calculus. In the illustrated embodiment,the barrier member 570 does not cover the entirety of the inlet. Rather,the barrier member 570 covers enough of the inlet 554 to preventcalculus from being discharged through the inlet and expelled outsidethe device during the forward axial movement of the plunger (and thesealing member 564), while permitting fluid to be discharged past thebarrier member 570 at the inlet 554.

From the position illustrated in FIG. 15D, further forward movement ofthe plunger 568 causes the entire sealing member 564 (i.e., the firstand second parts 576, 578 of the sealing member 564) as well as thefilter 566 to move together in the forward or distal direction indicatedby the arrow in FIG. 15D. As the operation of the calculusremoving/retrieving device 550 shifts from the position shown in FIG.15D toward the position shown in FIG. 15A, the barrier member 570 shiftsto the closed position shown in FIG. 15A. Between the positionillustrated in FIG. 15D and the position illustrated in FIG. 15A, thefirst and second parts 576, 578 of the sealing member 564 axially move asecond axial distance that is greater than the first axial distancediscussed above.

After the sealing member 564 reaches the end of its distal movement inthe forward direction, the plunger 568 is once again moved in therearward or proximal direction and the operation described above isrepeated. It is thus possible to repeatedly draw or suck calculus intothe interior of the tubular body 552 and to retain such calculus in theretrieval space 562. After the retrieval of the desired calculus iscompleted, the calculus removing/retrieving device 550 can be removedfrom the living body, thus removing the calculus from the living body.

FIGS. 16 and 17A-17D illustrate a further embodiment of the calculusremoving/retrieving device representing another example of the calculusremoving/retrieving device and operational method disclosed here.Features of this embodiment which are similar to features described inthe earlier embodiments are identified by common reference numerals, butpreceded by a “6”. A detailed description of features in this embodimentthat are similar to features in earlier embodiments is not repeated, andthe following detailed description focuses primarily on differencesbetween this embodiment and the earlier embodiment.

Referring initially to FIG. 16 the calculus removing/retrieving device650 includes an elongated member or tubular body 652 having an innersurface 658 surrounding an interior 660 within the tubular body 652. Inthis illustrated embodiment, the tubular body is a circular cylindricaltubular body, but the tubular body can have other tubular shapes otherthan a cylindrical-shape. The tubular body 652 includes an inlet 654 andan outlet 656. In the illustrated embodiment, the outlet 656 iscomprised of a plurality of circumferentially spaced apart outlets 656.Any desired number of outlets can be provided. The calculusremoving/retrieving device 650 can be outfitted with a barrier memberand a filter like those described above and shown in the drawing figuresto achieve favorable results similar to those described above.

The calculus removing/retrieving device 650 also includes a sealingmember 664. In this embodiment the sealing member 664 is a foldablesealing member that includes two seal parts 690, 692. The two seal partsinclude a first seal part 690 and a second seal part 692 that arefoldable relative to one another to move between a folded state in whichthe two parts overlap or overlie one another and a spread state in whichthe two seal parts 690, 692 are spread-out and lie in a common plane.

The sealing member 664 also includes two axles 694, 696. The two axlesinclude a first (proximal) axle 694 and a second (distal) axle 696. Thefirst seal part 690 and the second seal part 692 are both rotatablymounted on the first axle 694 so that the first and second seal parts690, 692 rotate about a common axis which, in this illustratedembodiment, is the axis of the first axle 694. The second axle 696 isconnected to the first seal part 690 by way of a pair of arms or links691. The second axle 696 is also connected to the second seal part 692by way of a pair of arms or links 693. One of the arms 691 is fixed tothe second axle 696 so that the arm rotates together with the secondaxle 696, while the other arm 691 is fixed to the first seal part 690 torotate together with the first seal part 690.

The second axle 696 is also connected to the second seal part 692 by wayof a pair of arms or links 693. One of the arms 693 is fixed to thefirst axle 696 while the other arm 693 is fixed to the second seal part692 to move together with the second seal part 692.

The plunger 668 possesses a distal end that is fixed to the first axle696 as illustrated in FIG. 16. The first axle 694 is comprised of twospaced apart axle parts 694′, 694″. The two axle parts 694′, 694″include a lower axle part 694′ and an upper axle part 694″.

Referring to FIG. 17A, the bottom interior surface of the tubular body652 is provided with a groove 695 that preferably extends along theentire axial or longitudinal extent of the tubular body 652. The lowerend of the first axle 694 (i.e., the lower axle part 694′) is alwayspositioned in the groove 695. When the sealing member 664 moves axiallywithin the interior of the tubular body 652 as described in more detailbelow, the second axle 694 (lower axle part 694′) is guided along thegroove 695. The second axle 696 need not be positioned in the groove695. More preferably though, both the first axle 694 and the second axle696 are positioned in the groove 695 to stabilize the axial mobility andmovement of the sealing member 664, but the second axle 696 isconfigured so that the second axle does not engage a proximal latch 698and does not engage a distal latch 699 (for example the outer diameterof the second axle 696 is smaller than the outer diameter of the firstaxle 694). In addition, for purposes of stabilizing the axial mobility,a second groove can be provided in the interior surface of the tubularbody 652 at a position opposite (diametrically opposed) to the groove695. It is also possible to provide the top interior surface of thetubular body 652 with a groove similar to the groove 695 that preferablyextends along the entire axial or longitudinal extent of the tubularbody 652. The upper end of the first axle 694 (i.e., the upper axle part694″) can be positioned in this groove 695 at the top interior surfaceof the tubular body 652 and moves along such groove when the sealingmember 664 moves axially within the interior of the tubular body 652.The upper end of the second axe can also be located in and move alongthis groove 695 at the top interior surface of the tubular body 652.

As illustrated in FIGS. 16 and 17A-17D, the proximal latch 698 and thedistal latch 699 are mounted on the interior of the tubular body 652.These latches 698, 699 are configured to engage the proximal axle 694(lower axle part 694′) when the sealing member 664 is positioned at thedistal end or proximal end of its axial travel extent. Specifically, thelatches 698, 699 are configured to engage and hold the proximal axle 694(lower axle part 694′) until a sufficient pulling or pushing forceapplied by the plunger 668 overcomes the holding force of the latch 698,699.

FIGS. 17A-17D provides a somewhat schematic illustration of one exampleof the proximal latch 698. The distal latch 699 can be similarlyconfigured and so the following description of features and operation ofthe proximal latch 698 applies equally to the distal latch 699. Thelatch generally includes a plate-shaped member 698′ provided with acurved groove or recess 698″ at its forward end. A spring 697 acts inopposition to a stop 697′ and applies a biasing force that urges theplate 698′ in the forward direction indicated by the arrow in FIGS. 17Aand 17B (i.e., toward the groove 695. The curved recess 698″ isconfigured to receive the proximal axle 694 (lower axle part 694′). Byappropriately selecting the depth of the curved recess 698″ and thebiasing force of the spring 697, it is possible to set the force,applied by the plunger 668, at which the proximal axle 694 (lower axlepart 694′) is released from the curved recess 698″.

The operation of the embodiment of the calculus removing/retrievingdevice shown in FIGS. 16 and 17A-17D is as follows. To start, thecalculus removing/retrieving device 650 is positioned in the living bodyin the manner described above so that the inlet 654 of the tubular body652 is located adjacent calculus to be retrieved and removed from theliving body. When the calculus removing/retrieving device 650 ispositioned adjacent the calculus, the calculus removing/retrievingdevice 650 is arranged generally in the manner illustrated in FIG. 17A.In this position the distal axle 696 is axially spaced distally from theproximal axle 694, and the first and second seal parts 690, 692 aregenerally folded towards one another so that the sealing member is inthe open position. In addition, when the sealing member 664 is in thedistal-most axial position shown in FIG. 17A, the proximal axle 694(lower axle part 694′) is located in the groove 695 and is held by thedistal latch 699.

Pulling the plunger 668 in the rearward or proximal direction causes thedistal axle 696 to move axially toward and relative to the proximal axle694. At this time, proximal axle 694 remains held in the distal latch699 and does not axially move. As the distal axle 696 approaches theproximal axle 694, the configuration of the arms 691, 693 causes thefirst and second seal parts 690, 692 to rotate about the axis of theproximal axle 694 so that the first and second seal parts 690, 692spread-out as illustrated in FIG. 17B. The sealing member 664 is thusshifted from the folded position shown in FIG. 17A to the spreadposition (closed position) depicted in FIG. 17B.

In the closed position shown in FIG. 17B, the outer peripheral surfacesof the first and second seal parts 690, 692 contact the inner surface658 of the tubular body 652 to form a seal contact. As the sealingmember moves from the spread-out position or closed position (i.e., theposition shown in FIG. 17B) toward the folded position or open position(i.e., the position shown in FIGS. 17A and 17D), the contact areabetween the outer peripheral surface of the sealing member and the innersurface 658 of the tubular body 652 (i.e., the contact area between theouter peripheral surfaces of the first and second seal parts 690, 692and the inner surface 658 of the tubular body 652) decreases. As thesealing member moves from the folded position or open position (i.e.,the position shown in FIGS. 17A and 17D) toward the spread-out positionor closed position (i.e., the position shown in FIG. 17B), the contactarea between the outer peripheral surface of the sealing member and theinner surface 658 of the tubular body 652 (i.e., the contact areabetween the outer peripheral surfaces of the first and second seal parts690, 692 and the inner surface 658 of the tubular body 652) increases.The maximum contact area between the outer peripheral surface of thesealing member and the inner surface 658 of the tubular body 652 occurswhen the sealing member 664 is in the spread-out position or closedposition (i.e., the position shown in FIG. 17B), while the minimumcontact area between the outer peripheral surface of the sealing memberand the inner surface 658 of the tubular body 652 occurs when thesealing member 664 is in the folded position or open position (i.e., theposition shown in FIGS. 17A and 17D). Also, the contact area between theouter peripheral surface of the sealing member 664 and the inner surfaceof the tubular body 652 is relatively large while moving the sealingmember 664 in the proximal direction and is relatively small when movingthe sealing member 664 in the distal direction.

Once the first and second seal parts 690, 692 reach the spread(spread-out) position so that the sealing member 664 is in the closedposition shown in FIG. 17B, the distal axle 696 is not able to moverelative to the proximal axle 694. Between the position illustrated inFIG. 17A and the position illustrated in FIG. 17B, the distal axle 696of the sealing member 664 moves a first axial distance relative to theproximal axle 694 of the sealing member 664.

When the calculus removing/retrieving device 650 reaches the positionshown in FIG. 17B, further pulling on the plunger 668 causes theproximal axle 694 (lower axle part 694′) to be released from the distallatch 699 so that the proximal axle 694 (lower axle part 694′) canaxially move in the rearward direction while being guided in the groove695. Thus, the distal latch 699 is configured to retain or hold theproximal axle 694 until the distal axle 696 is positioned at theposition shown in FIG. 17B and the sealing member 694 (two seal parts690, 692) is in the spread position shown in FIG. 17B.

When the plunger 668 is further pulled in the rearward or proximaldirection after the calculus removing/retrieving device 650 reaches theposition shown in FIG. 17B, the sealing member 664 axially moves in therearward or proximal direction within the tubular body 652. Thisrearward or proximal movement of the sealing member 664 results incalculus and fluid being drawn into the interior of the tubular body 652by way of the inlet 654. At approximately the same time discharging ofthe fluid that has been introduced into the space between the proximalsurface of the sealing member 694 and the closed end of the tubular body652 by way of the outlet occurs, if the space between the proximalsurface of the sealing member 694 and the closed end of the tubular body652 has been filled by the fluid to some extent. With continued axialmovement of the sealing member 664 in the tubular body 652, the sealingmember eventually reaches the position illustrated in FIG. 17C in whichthe proximal axle 694 (lower axle part 694′) is engaged by the proximallatch 698. The proximal axle 694 is thus held in this proximal-mostaxial position by the proximal latch 698 when the sealing member 664 isin the position shown in FIG. 17C.

The plunger 668 is then moved in the forward or distal direction asgenerally illustrated in FIG. 17D. The proximal axle 694 is held by theproximal latch 698 during this initial forward movement of the plunger668 and so the distal axle 696 moves relative to and away from theproximal axle 694 as generally shown in FIG. 17D. That is, the proximalaxle 694 remains stationary, by virtue of being held by the proximallatch 698, while the distal axle 696 moves axially relative to theproximal axle 694 in a direction toward the inlet 654 of the tubularbody 652. The movement of the distal axle 696 relative to the proximalaxle 694 causes the first and second seal parts 690, 692 to shift fromthe spread position (closed sealing position) in which the sealingmember 664 is closed to the folded position shown in FIG. 19D in whichthe sealing member 664 is open. In the open position of the sealingmember 664, fluid is able to flow past the first and second seal parts690, 692 so that when the plunger 668 is pushed and axially moved in theforward or distal direction, the plunger 668 and the sealing member 664don't create both suction and exhaust, but rather only the position ofthe plunger 668 and the sealing member 664 changes. In addition, thebarrier member covers enough (sufficient amount or area) of the inlet654 to prevent retrieved calculus in the retrieval space 662 from beingdischarged through the inlet and expelled outside the device during theforward axial movement of the plunger 668 and the sealing member 664.

After the distal axle 696 has moved relative to the proximal axle 694 tothe maximum extent permitted by the arms 691, 693 as shown in FIG. 17D,further pushing on the plunger 668 causes the proximal axle 694 to bereleased from the proximal latch 698. From the position illustrated inFIG. 17C to the position shown in FIG. 17D, the distal axle 696 moves afirst axial distance which is the same as the first axial distancediscussed earlier (i.e., the first axial distance moved by the distalaxle between the FIG. 17A position and the FIG. 17B position.

After the proximal axle 694 is released by the proximal latch 698 due tocontinued pushing of the plunger 668, the sealing member 664 movesaxially within the interior of the tubular body 652 while the first andsecond seal parts 690, 692 remain in the folded condition relative toone another (the folded condition shown in FIG. 17D) so that the sealingmember 664 is in the open condition. Fluid which has been drawn orsucked into the interior of the tubular body 652 is able to flow pastthe sealing member. Calculus which has previously been retrieved and islocated in the retrieval space 662 is not able to flow proximally pastthe folded seal parts 690, 692 of the sealing member 694 in the openposition shown in FIG. 17D because the barrier member covers enough(sufficient amount or area) of the inlet 654 to prevent calculus frombeing discharged through the inlet 654. In addition, the calculusremoving/retrieving device 650 can be equipped with a filter (similar tothe filters 66, 166, 266, 366, 566 described above and illustrated inthe drawing figures) that is specifically sized to permit the passage offluid, yet prevent the passage of calculus in front of the sealingmember 664. The calculus is thus retained in the space between thefilter and the closed-state barrier member during the manipulation fromFIG. 17A to 17D. With continued forward pushing of the plunger 668, thesealing member eventually reaches the distal end of the forward movementstroke of the plunger 668 and the proximal axle 694 (lower axle part694′) is engaged by the distal latch 699.

The operation described above is then repeated as many times as desiredto draw additional calculus into the interior of the tubular body.

FIGS. 18A-18C illustrate a further embodiment of the device representinganother example of the calculus removing/retrieving device andoperational method disclosed here. Features of this embodiment which aresimilar to features described in the earlier embodiments are identifiedby common reference numerals, but preceded by a “7”. A detaileddescription of features in this embodiment that are similar to featuresin earlier embodiments is not repeated, and the following detaileddescription focuses primarily on differences between this embodiment andthe earlier embodiment.

FIGS. 18A-18C illustrate a portion of the calculus removing/retrievingdevice 750. This embodiment includes a plunger 768 connected to asealing member 764. The sealing member 764 is disc-shaped and possessesan outer peripheral surface in substantial sealing contact with theinner surface of the elongated body (inner surface surrounding the lumenin the elongated body 752). The elongated body 752 can be configured ina manner similar to that shown in FIG. 2. The sealing member 764includes a plurality of through holes 786 and a plurality of one wayvalves (flap valves or valve elements) 787 connected to the disc-shapedpart of the sealing member 764. Each of the valves 787 is associatedwith a respective one of the through holes 786 so that valve 787 canmove between an open position shown in FIG. 18C in which fluid flowthrough the through holes 786 is permitted and a closed position shownin FIG. 18B in which fluid flow through the through holes 786 isprevented. This embodiment of the calculus removing/retrieving device750 can be used without the filter used in other embodiments. Thisembodiment preferably includes one of the barrier (cover members) usedin other embodiments. The sealing member 764 together with the plunger768 is positioned in the elongated member or tubular body 752, and isaxially movable in the forward (distal) direction as well as therearward (proximal) direction.

The operation of the calculus removing/retrieving device 750 is similarto operational aspects of other embodiments of the device describedabove. The calculus removing/retrieving device 750 can be connected toan operating member, for example the operating member 30 shown inFIG. 1. The calculus removing/retrieving device 750 is then insertedinto the living body and advanced to the location of the calculus to beretrieved and removed. This can be accomplished in the manner describedpreviously. When the inlet of the tubular body 752 is appropriatelypositioned for retrieval and removal of calculus (e.g., the inlet ispositioned near the calculus to be retrieved and removed), the plunger768 is axially moved in the rearward or proximal direction (by operatingthe operating member which pulls the manipulation wire and rearwardlymoves the plunger 768). The rearward movement of the plunger 768 causesthe sealing member 764 to also move in the rearward or proximaldirection as illustrated in FIG. 18B. This rearward or proximaldirection movement of the plunger and the sealing member 764 isidentified by the left-most arrow in FIG. 18B. The other arrows in FIG.18B depict the fluid flow (force) which urges the one-way valves 787into covering relation to the respective through holes 786 so that thevalves adopt a closed position. This rearward movement of the sealingmember 764 draws calculus and fluid, located in the lumen of the livingbody, into the retrieval space 762 in the tubular body 752 through theinlet at the forward end (distal end) of the tubular body 752.

When the sealing member 764 reaches the end of its rearward stroke, thesealing member 764 is moved in the forward (distal) direction by pushingor moving the plunger 768 in the forward direction. This forwarddirection of movement of the plunger 768 and the sealing member 764 isidentified by the left-most arrow in FIG. 18C. The other arrows in FIG.18C depict the fluid flow (force) which urges the one-way valves 787away from the respective through holes 786 so that the valves adopt anopen position as shown in FIG. 18C. The valves 787 in the open positionallow fluid to pass through the through holes 786 of the sealing member764 as the sealing member 764 moves in the distal direction. Fluid inthe retrieval space 362 is able to pass through the through holes 786 asindicated by the leftward-pointing arrows in FIG. 18C. The through holes786 are sized or configured to permit fluid to pass through the throughholes 786 while preventing calculus (calculi) from passing through thethrough holes 786. Each of the through holes 786 could be provided witha filter or screen covering the through hole 786 to help preventcalculus (calculi) from passing through the through holes 786.

When the sealing member 764 reaches the end of its forward stroke, thesealing member 764 is once again moved in the rearward direction bypulling or moving the plunger 768 in the rearward direction as discussedabove. This rearward and forward movement of the sealing member 764 canbe repeated to collect the desired amount of calculus in the retrievalspace.

The detailed description above describes a device and method forretrieving/removing calculus from parts of a living body such as theureter and the renal pelvis. The invention is not limited, however, tothe precise embodiments and variations described. Various changes,modifications and equivalents can be effected by one skilled in the artwithout departing from the spirit and scope of the invention as definedin the accompanying claims. It is expressly intended that all suchchanges, modifications and equivalents which fall within the scope ofthe claims are embraced by the claims.

What is claimed is:
 1. A device for retrieving calculus in a lumen of aliving body comprising: an elongated member possessing an outerdimension configured to permit the elongated member to be positioned inthe lumen of the living body, the elongated member including a lumenpossessing an inner surface, the elongated member also including aninlet, an outlet and a retrieval space in the lumen; a sealing membermovably positioned in the lumen of the elongated member to axially movein a distal direction in the lumen toward the inlet and to axially movein a proximal direction in the lumen; the sealing member comprising afirst part positioned in the lumen of the elongated member and a secondpart positioned in the lumen of the elongated member, the second partbeing positioned distally of the first part so that the second part islocated axially between the inlet and the first part; the second partpossessing an outer surface in sealing contact with the inner surface ofthe lumen in the elongated member; and the first part and the secondpart of the sealing member being axially movable relative to one anotherin the lumen when the sealing member is moved in the distal direction sothat the first part and the second part are axially spaced apart fromone another, and also being axially movable together as a unit in thelumen when the sealing member is moved in the proximal direction.
 2. Thedevice according to claim 1, wherein the first part possesses an axiallyfacing end surface facing an axially facing end surface of the secondpart, the axially facing end surface of the first part being in directcontact with the axially facing end surface of the second part duringmovement of the sealing member in the proximal direction.
 3. The deviceaccording to claim 1, wherein the first part possesses an axially facingend surface facing an axially facing end surface of the second part, theaxially facing end surface of the first part being axially spaced apartfrom the axially facing end surface of the second part when the sealingmember is moved in the distal direction.
 4. The device according toclaim 1, further comprising a filter fixed to and movable together withthe second part so that the filter is positioned axially between theretrieval space and the second part and so that the second part ispositioned axially between the filter and the first part, the filterpermitting the fluid in the retrieval space to pass through the filteras the fluid flows toward the outlet, and the filter preventing thecalculus in the retrieval space from passing through the filter so thatthe calculus remains in the retrieval space.
 5. The device according toclaim 1, wherein the second part possesses a distal facing surfacefacing towards the distal direction, further comprising a filter fixedto the distal facing surface of the second part so that the filter ispositioned axially between the retrieval space and the second part andso that the second part is positioned axially between the filter and thefirst part, the filter permitting the fluid in the retrieval space topass through the filter as the fluid flows toward the outlet, and thefilter preventing the calculus in the retrieval space from passingthrough the filter so that the calculus remains in the retrieval space.6. The device according to claim 1, wherein the second part includes anopening and the first part includes a projection that fits into theopening when the sealing member moves in the proximal direction.
 7. Thedevice according to claim 1, wherein the second part includes a flatsurface and the first part includes an opening that contact with theflat surface when the sealing member moves in the proximal direction. 8.The device according to claim 1, wherein the second part includes aplurality of through holes through which the fluid in the retrievalspace passes when the sealing member moves in the distal direction. 9.The device according to claim 1, further comprising an elongated plungerthat passes through a through hole in the first part so that the plungeris axially movable relative to the first part, the elongated plungerbeing fixed to the second part so that all axial movement of the plungerresults in axial movement of the second part.
 10. The device accordingto claim 9, wherein the second part of the sealing member is axiallymovable in the distal direction relative to the first sealing memberover a first axial distance, and further comprising a push member fixedto the plunger on a proximal side of the first part so that the plungerand the push member move together as a unit, the push member contactingthe first part of the sealing member after the second part of thesealing member has moved the first axial distance in the distaldirection relative to the first part of the sealing member, the contactof the push member with the first part of the sealing member causingboth the first part of the sealing member and the second part of thesealing member to move together in the distal direction upon furtheraxial movement of the plunger in the distal direction.
 11. The deviceaccording to claim 1, further comprising a barrier positioned at theinlet to the elongated member, the barrier including a plurality ofmovable cover parts each movable between an open position permitting thecalculus to be drawn through the inlet and into the retrieval space whenthe sealing member is moved in the proximal direction and a closedposition in which each cover part covers a part of the inlet to preventthe calculus located in the retrieval space from flowing out through theinlet when the sealing member is moved in the distal direction.
 12. Thedevice according to claim 1, further comprising a barrier positioned atthe inlet to the elongated member, the barrier including a plurality offoldable cover parts each connected to the sealing member so that thecover parts move together with movement of the sealing member between afolded position in which each cover part is folded to cover a part ofthe inlet to prevent the calculus located in the retrieval space fromflowing out through the inlet when the sealing member is moved in thedistal direction and an unfolded position in which each cover part isunfolded to permit the calculus in the lumen to be drawn through theinlet and into the retrieval space when the sealing member is moved inthe proximal direction.
 13. A device for retrieving calculus in a lumenof a living body comprising: an elongated member possessing an outerdimension configured to permit the elongated member to be positioned inthe lumen of the living body, the elongated member possessing a distalend portion and a lumen at the distal end portion of the elongatedmember, the lumen in the distal end portion of the elongated memberpossessing an inner surface; the elongated member also including aninlet, an outlet and a retrieval space in the lumen at a positionbetween the inlet and the outlet; a sealing member movably positioned inthe lumen of the elongated member to axially move in a distal directionin the lumen and in a proximal direction in the lumen, the sealingmember possessing an outer peripheral surface in sealing contact withthe inner surface of the lumen in the elongated member; a plungerconnected to the sealing member so that axial movement of the plungeraxially moves the sealing member in the lumen; and the sealing memberincluding two parts that are separated from one another to form adivided sealing member when the plunger is moved in the distal directionand that directly contact one another to form an integrated sealingmember when the plunger is moved in the proximal direction to draw fluidand the calculus into the retrieval space.
 14. The device according toclaim 13, wherein the two parts of the sealing member include a firstpart and a second part, the first part being positioned axially betweenthe second part and the outlet, the first part including at least onethrough hole through which the fluid in the retrieval space passes whenthe sealing member moves in the distal direction.
 15. The deviceaccording to claim 13, wherein the two parts of the sealing memberinclude a first part and a second part, the second part being positionedaxially between the retrieval space and the first part, the second partincluding at least one aperture.
 16. The device according to claim 13,wherein the two parts of the sealing member include a first part and asecond part, the first part being positioned axially between the secondpart and the outlet, the first part including at least one through holewhich is open when the two parts of the sealing member are separatedduring the movement of the plunger in the distal direction so that thefluid in the retrieval space flows through the through hole in the firstpart and flows toward the outlet, the at least one through hole in thefirst part being closed when the two parts of the sealing memberdirectly contact one another during the movement of the plunger in theproximal direction.
 17. The device according to claim 13, wherein thetwo parts of the sealing member include a first part and a second part,the second part being positioned axially between the retrieval space andthe first part, one of the first part and the second part including aprotrusion and the other of the first part and the second part includingan aperture in which the protrusion is positioned during the movement ofthe plunger in the proximal direction.
 18. The device according to claim13, wherein the sealing member includes a filter configured to allow thefluid in the retrieval space to pass through the filter while preventingthe calculus in the retrieval space from passing through the filter. 19.The device according to claim 13, wherein the two parts of the sealingmember include a first part and a second part, the second part beingpositioned axially between the retrieval space and the first part, thesecond part of the sealing member being axially movable in the distaldirection relative to the first sealing member over a first axialdistance, and further comprising a push member fixed to the plunger on aproximal side of the first part so that the plunger and the push membermove together as a unit, the push member contacting the first part ofthe sealing member after the second part of the sealing member has movedthe first axial distance in the distal direction relative to the firstpart of the sealing member, the contact of the push member with thefirst part of the sealing member causing both the first part of thesealing member and the second part of the sealing member to movetogether in the distal direction upon further axial movement of theplunger in the distal direction.
 20. The device according to claim 13,further comprising a barrier positioned at the inlet to the elongatedmember, the barrier including at least one cover part movable between anopen position permitting the calculus to be drawn through the inlet andinto the retrieval space when the sealing member is moved in theproximal direction and a closed position in which the cover part coversa part of the inlet to prevent the calculus located in the retrievalspace from flowing out through the inlet when the sealing member ismoved in the distal direction.